Neighborhood Greenness & Cardiometabolic Health among Hispanics in the HCHS/SOL Study ABSTRACT Project Summary: Hispanics/Latinos, the largest U.S. minority group, are at relatively high risk for metabolic syndrome (MetS). Neighborhood greenness (vegetative presence) is a novel and understudied protective factor for MetS that has not yet been systematically studied across Hispanic heritage groups. The NHLBI-funded Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is an epidemiologic study with an emphasis on cardiovascular disease and related risk factors such as MetS, diabetes and hypertension. Building on the HCHS/SOL study, the proposed study will be the first to investigate prospectively and longitudinally, the impact of neighborhood cumulative greenness exposure on MetS indicators within and across Hispanic subgroups. It will do so using the full sample of ~8,000 participants for the Miami and San Diego HCHS/SOL sites, which are two U.S. areas with significant Hispanic/Latino populations. Because both communities are undergoing significant greening interventions, the proposed study will investigate the impact of the natural experiment in greening on MetS in both cities. This proposal will obtain residential location from Visit 1 (2008-2011), Visit 2 (~6 years later), and intervening annual follow-ups to calculate from high resolution satellite imagery cumulative greenness exposure for each participant, and determine its relationship to central adiposity (waist circumference) and 4 other MetS indicators (i.e., blood pressure, triglycerides, low HDL cholesterol, fasting glucose). Cumulative exposure to neighborhood greenness will be assessed, reflecting moves and changes in environments. Multi- group analyses will examine differences in the relationship of cumulative greenness to MetS indicators, by sex, by site and by the three larger Hispanic subgroups. Hypothesized biological pathways will be examined: specifically, greenness? relationship to changes in waist circumference, which may in turn impact the other 4 MetS indicators through each of: (a) insulin resistance, measured by HOMA-IR, and (b) inflammation, measured by C-Reactive Protein, respectively. Hypothesized moderators (e.g., sex; neighborhood walkability) of greenness to MetS indicators will be examined. Planned post-hoc analyses will examine changes in greenness (e.g., tree-planting) in relation to risk for MetS, diabetes, hypertension, and hyperlipidemia, and possible roles of physical activity and social support (available for a subset of SOL participants) as pathways in the relationship of greenness to biomarkers (insulin resistance, inflammation). HCHS/SOL recently completed Visit 2, making this proposal timely. PIs at the two participating HCHS/SOL Study sites and Coordinating Center will be integral to the conduct of the proposed study. Several factors increase the efficient and cost- effective accomplishment of study aims: effective recruitment/retention strategies; a large array of data on cardiometabolic health outcomes and related behavioral/biological risk factors in a diverse sample of Hispanics/Latinos; a Coordinating Center to facilitate data access; and HCHS/SOL?s team science approach.